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Urine Uric Acid

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261. Praxbind - idarucizumab

DNA Deoxyribonucleic acid DP drug product DS drug substance DSC differential scanning calorimetry dTT Diluted thrombin time DV dependent variable DVT Deep vein thrombosis EBE empirical Bayes estimates EC50 drug concentrations to achieve 50% of the maximum effect ECT Ecarin clotting time EDQM European Directorate for the Quality of Medicines and Healthcare EMA European Medicines Agency Emax maximum observed or estimated efficacy or PD effect Epsilon ( ?) residual variability in NONMEM EST (...) . Idarucizumab binds to dabigatran with a higher affinity than dabigatran binds thrombin. The biological activity of idarucizumab is determined by a thrombin clotting assay. The drug product is presented as a solution for injection/infusion containing 2.5 g/50 mL idarucizumab as active substance. Other ingredients are sodium acetate trihydrate, acetic acid, sorbitol, polysorbate 20 and water for injection. The product is available in a 50 mL glass vial (type I glass), with a butyl rubber stopper

2015 European Medicines Agency - EPARs

262. Raxone - idebenone

in the relative frequency worldwide. All of the three main primary LHON mutations result in amino acid changes in complex I (NADH:ubiquinone oxidoreductase) of the mitochondrial respiratory chain. In LHON patients, this change leads to a defect in complex I and disrupts the electron transport chain. However, the mutations are not always associated with a measurable respiratory chain abnormality. Experimental evidence connects complex I dysfunction to elevated levels of oxidative stress, reduced mitochondrial (...) structure: The structure of the active substance has been confirmed by IR, MS, NMR ( 13 C and 1 H), X-ray crystallography, and UV, all of which support the chemical structure. It appears as a yellow-orange crystalline, non-hygroscopic powder. It is insoluble in water and freely soluble in ethanol. No dissociation constant has been calculated because idebenone has neither basic nor acidic function. Its logP oct/wat was found to be 3.93 at 25°C. Idebenone is achiral. Two structurally distinct crystal

2015 European Medicines Agency - EPARs

265. Newborn Nursing Care Pathway

to identify variances that may require further assessments Refer to: • Feeding • Weight Norm and Normal Variations • One clear void with possible uric acid crystals (orange/brownish color) • Urine pale yellow and odorless Parent education/ Anticipatory Guidance • Refer to >12 – 24 hr Variance • Refer to >12 – 24 hr Intervention • Refer to >12 – 24 hr Norm and Normal Variations • Voids within 24 hr • = 1 wet, clear, pale yellow diaper(s) 29 • Uric acid crystals in the first 24 hr Parent education (...) and pale yellow 34 Parent education/ Anticipatory Guidance • Refer to >12 – 24 hr Variance • Refer to >24 – 72 hr • Uric acid crystals may indicate dehydration after 72 hours • Urine concentrated • 12 – 24 hr Refer to: Healthy Families BC Website – Physiological Health: elimination – u rine23 Newborn Guideline 13: Newborn Nursing Care Pathway Physiological Assessment 0 – 12 hours Period of Stability (POS) >12 – 24 hours >24 – 72 hours >72 hours – 7 days and beyond

2015 British Columbia Perinatal Health Program

266. Autosomal Dominant Polycystic Kidney Disease - Diet and Lifestyle Management

-protein diet (0.58 g/kg/d) or a very low protein diet (0.28 g/kg/ d supplemented with keto and amino acids). Patients were included in the study if they met the GFR criteria respective to Study A or Study B (as stated earlier), their mean arterial pressure was less than 125 mm Hg, and their dietary protein intake was greater than or equal to 0.9 g/kg body weight/d. The primary outcome for the MDRD study was GFR decline measured by 125 I-iothalamate clearance every 4 months. Klahr et al, 9 in 1995 (...) , the effect of increased ?uid intake (beyond thirst) on renal disease progression in humans with ADPKD is not known. The available data are limited and include a single post hoc analytical study, 36 two short-term interventional trials (o1 wk) without con- trol groups, 37,38 and a single long-term observational cohort study of 12 months. 39 A post hoc analysis of the well-known MDRD trial examined the relationship between GFR decline and urine volume (an indirect marker of ?uid intake). 36 During the MDRD

2015 KHA-CARI Guidelines

267. Heart failure - chronic

factors and to exclude with similar presentations. Possible tests include: Chest X-ray. Blood tests such as urea and electrolytes, estimated glomerular filtration rate (eGFR), full blood count, thyroid function tests, liver function tests, HbA1c, and fasting lipids. Urine dipstick for blood and protein. Lung function tests (peak flow and/or spirometry). Assess for and manage any underlying where appropriate. People with heart failure due to valve disease should be referred for specialist assessment

2019 NICE Clinical Knowledge Summaries

268. Effects of antioxidant-rich foods on altitude-induced oxidative stress and inflammation in elite endurance athletes: A randomized controlled trial. Full Text available with Trip Pro

(23 ± 5 years), ingested antioxidant-rich foods (n = 16), (> doubling their usual intake), or eucaloric control foods (n = 15) during a 3-week altitude training camp (2320 m). Fasting blood and urine samples were collected 7 days pre-altitude, after 5 and 18 days at altitude, and 7 days post-altitude. Change over time was compared between the groups using mixed models for antioxidant capacity [uric acid-free (ferric reducing ability of plasma (FRAP)], oxidative stress (8-epi-PGF2α

2019 PLoS ONE Controlled trial quality: uncertain

269. Biochemical metabolic levels and vitamin D receptor FokⅠ gene polymorphisms in Uyghur children with urolithiasis. Full Text available with Trip Pro

) and serum chlorine (Cl) (OR = 0.93, 95% CI: 0.88-0.97) were related to Uyghur children urolithiasis risk. A multiple logistic regression model showed CO2CP (OR = 1.17, 95% CI: 1.09-1.26), levels of uric acid (OR = 1.01, 95% CI: 1.00-1.01) and serum sodium (Na) (OR = 0.90, 95% CI: 0.82-0.99) were associated with pediatric urolithiasis. The risk of urolithiasis was increased with the F versus f allele overall (OR = 1.42; 95% CI: 1.01-2.00) and for males (OR = 1.52, 95% CI: 1.02-2.27). However, metabolic (...) levels did not differ by FokⅠ genotypes. In our population, CO2CP and levels of uric acid and serum Na as well as polymorphism of the F allele of the VDR FokⅠ may provide important clues to evaluate the risk of urolithiasis in Uyghur children.

2019 PLoS ONE

270. Rasburicase in hemolytic uremic syndrome related to Shiga toxin-producing Escherichia coli: a report of nine cases. (Abstract)

Rasburicase in hemolytic uremic syndrome related to Shiga toxin-producing Escherichia coli: a report of nine cases. Hyperuricemia might induce additional renal damage in children with hemolytic uremic syndrome related to Shiga toxin-producing Escherichia coli (STEC-HUS). A few case reports have shown rasburicase to be effective in decreasing serum uric acid (UA) and improving renal function. However, there is only one report on the use of rasburicase in a child with STEC-HUS, which shows (...) satisfactory results. We describe here the safety and efficacy of rasburicase in nine additional cases.Data from 9 children (5 females, median age 2 years) who received rasburicase were reviewed. At admission, 6 were dehydrated and 3 euvolemic. Dehydrated patients received saline solution and afterwards, as well as for those initially euvolemic, we aimed to keep a neutral fluid balance. Despite this, urine output did not increase. Baseline creatinine was 3.35 mg/dL (1.47-9.1) and UA 11.4 mg/dL (8.3-19.2

2020 Pediatric Nephrology

271. Predictive Factors for Kidney Stone Recurrence in Type 2 Diabetes Mellitus. (Abstract)

-1.047), urine pH (OR 0.500, CI 0.043-0.581), HbA1c (OR 1.186, CI 1.012-1.277), diabetic neuropathy (OR 1.839, CI 1.413-2.392), diabetic retinopathy (OR 1.690, CI 1.122-2.546), insulin as well as potassium citrate therapy (OR 0.611, CI 0.426-0.87), and stone with calcium oxalate and uric acid composition (OR 1.955, CI 1.420-2.691 and OR 2.221, CI 1.249-3.949, respectively) are significant predictors for stone recurrence.The severity of diabetes and stone composition are strong predictors for stone (...) recurrence in type 2 diabetic patients, while HbA1c and urine pH are important modifiable factors.Copyright © 2020 Elsevier Inc. All rights reserved.

2020 Urology

272. Association of Impaired Renal Function With Changes in Urinary Mineral Excretion and Stone Composition. (Abstract)

, and stone characteristics were reported. The patients' estimated glomerular filtration rates (eGFR) were compared with their stone compositions and 24-hour urine mineral excretions.A statistically significant difference was noted between the groups, with uric acid stones being associated with lower eGFR and calcium phosphate stones associated with higher eGFR. No relationship could be demonstrated between eGFR and calcium oxalate or struvite stones. Patients with lower eGFR also demonstrated

2020 Urology


ammonium. In our study cohort, patients with elevated urinary ammonium also showed higher urine volume, oxalate, calcium, uric acid, sodium, chloride and sulfate. Clinically, these patients had higher BMI, and more often had a history of recurrent urinary tract infections, diabetes, gout, bowel resection and urinary reconstruction history. Struvite stones tended to be more common in the elevated ammonium group versus control (n=7 vs 1, p=0.07).Elevated urinary ammonium among kidney stone patients (...) NEPHROLITHIASIS AND ELEVATED URINARY AMMONIUM: A MATCHED COMPARATIVE STUDY. To describe the associations between elevated urinary ammonium and clinical characteristics of kidney stone formers. A 24-hour urine test is recommended in high-risk patients to identify urinary abnormalities and select interventions to reduce the recurrence risk. While elevations in urine ammonium may be seen in acidosis, diarrhea, high protein diets or due to pathogenic bacteria, the clinical characteristics

2020 Urology

274. CUA guideline on the evaluation and medical management of the kidney stone patient

, Grade C Recommendation): 14-20 • Children ( 5.8 serum bicarbonate serum potassium Pure apatite stone Hypocitraturia Serum electrolytes Urine pH Ammonium chloride load test* Potassium citrate *Optional; PTH: parathyroid hormone; ?: high; ?N: at the high end of normal range; : low.CUAJ • November-December 2016 • Volume 10, Issues 11-12 E354 dion et al. Focus of treatment for uric acid stones should, therefore, primarily be to correct urine pH above 5.5 and increase urine volume rather than institute (...) excretion. This results in unbuffered hydrogen ions and a lowering of the urinary pH. 134 Based on the num- ber of metabolic syndrome traits, the risk of stone formation may go up two-fold. 135 Dietary and medical prophylaxis options are shown in Fig. 2. In patients with uric acid stones, alkalinization of the urine targeting a urine pH of 6.5 is the first-line therapy. Allopurinol may be used as adjunctive therapy in patients with hyperuricemia or hyperuricosuria (Level of Evidence 1-3, Grade B

2016 Canadian Urological Association

275. Can a Spot Urine Replace or Improve 24 Hour Urine Collections in Kidney Stone Patients

.), different crystals may precipitate. Therefore therapy is tailored to the individual, based on stone composition and the results of the 24-hour urine collection. The majority of the stones are calcium based (calcium oxalate, calcium phosphate) while the remaining are comprised of uric acid, struvite, cystine or other substances. While some stones can pass spontaneously, the majority will require some form of treatment, and more than 50% will require surgical intervention. Until the 1980s, treatment (...) : All Accepts Healthy Volunteers: No Sampling Method: Non-Probability Sample Study Population Patients receiving care at Vancouver General Hospital for their kidney stone disease. Criteria Inclusion Criteria: Patients who have been diagnosed as having calcium based urinary stones at least 19 years of age do not have any additional serious disease Exclusion Criteria: Patients who do not have calcium based urinary stones (such as: uric acid, cystine, struvite) less than 19 years of age have a serious

2010 Clinical Trials

276. Management of Ureteral Calculi

to SWL and may be better served by ureteroscopic management. 12 Moreover, in the case of cystine and calcium oxalate monohydrate, the frag- ments created by SWL may be large which can result in poor clearance. Uric acid stones, while fragile in the face of SWL, present a challenge with respect to localization for SWL treatment. Either the use of ultrasound or pyelography (IVP or retrograde) is required to target the stone. In addition, follow-up cannot be completed in the conventional fashion (...) with plain radiography, and requires the use of either ultra- sound or, more often, CT scanning to ensure the patient is successfully treated. In many instances the exact stone composition will not be known prior to treatment, or in the case of recurrent stone formers, it may have changed over time. 13 Non-contrast CT scans using dual energy can distinguish some types of stones in vivo. Uric acid stones can be differentiated from calcium stones; however, there is significant overlap in the attenua- tion

2015 Canadian Urological Association

277. Polycythaemia/erythrocytosis

but clinically normal haemoglobin. JAK2 V617F mutation — positive finding is definitive for polycythaemia vera. Negative finding does not rule it out as around 5% of cases involve other mutations. Serum uric acid (optional) — frequently elevated in polycythaemia vera. Abdominal ultrasound — to detect splenomegaly (suggestive of polycythaemia vera) where physical examination is equivocal. Differential diagnosis What else might it be? The differential diagnoses of polycythaemia vera include: Essential (...) , leading to secondary erythrocytosis. Examine the digits, measure oxygen saturation, and listen to the chest — clubbing of digits, oxygen saturation <92% in room air, and/or abnormal heart or breath sounds may suggest secondary erythrocytosis caused by underlying cardiopulmonary disease. Carry out urine dipstick analysis to identify possible renal causes of secondary erythrocytosis. Consider . Take blood samples (without a tourniquet if possible) for haemoglobin, mean corpuscular volume (MCV

2018 NICE Clinical Knowledge Summaries

278. Contrast-induced Nephropathy

bicarbonate versus N-acetylcysteine plus IV saline; 8 RCTs comparing a statin versus IV saline; 5 RCTs comparing a statin plus N-acetylcysteine versus N-acetylcysteine; 6 RCTs comparing statin versus statin, statin by dose, or statins plus other agents; 5 RCTs comparing an adenosine antagonist versus IV saline; 6 RCTs investigating hemodialysis or hemofiltration versus IV saline; 6 RCTs comparing ascorbic acid versus IV saline, and 3 RCTs comparing ascorbic acid to N-acetylcysteine. Although we found many (...) of CIN (RR, 0.93; 95% CI, 0.68 to 1.27). The SOE was low for a clinically important reduction in CIN that was not statistically significant when comparing IV sodium bicarbonate with IV saline in patients receiving LOCM (RR, 0.65; 95% CI, 0.33 to 1.25). The SOE was low for a clinically important reduction in CIN that was not statistically significant when comparing ascorbic acid with IV saline (RR, 0.72; 95% CI, 0.48 to 1.01). The SOE was low that use of hemodialysis versus IV saline to prevent CIN

2016 Effective Health Care Program (AHRQ)

279. Screening for Chronic Kidney Disease in Adult Males in Vojvodina: A Cross-sectional Study Full Text available with Trip Pro

, based on estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR), and exploring the determinants and awareness of CKD.This cross-sectional study included 3060 male examinees from the general population, over 18 years of age, whose eGFR and ACR were calculated, first morning urine specimen examined, arterial blood pressure measured and body mass index calculated. Standard biochemistry methods determined creatinine, urea, uric acid and glucose serum concentrations as well (...) as albumin and creatinine urine levels.Prevalence of CKD in the adult male population is 7.9%, highest in men over 65 years of age (46.7%), while in the other age groups it is 3.6-12.6%. The largest number of examinees with a positive CKD marker suffer from arterial hypertension (HTA) and diabetes mellitus (DM). Only 1.3% of examinees with eGFR<60 ml/min/1.73 m2 and/or ACR≥ 3 mg/mmol had been aware of positive CKD biomarkers.Obtained results show the prevalence of CKD in adult males is 7.9%, HTA and DM

2017 Journal of medical biochemistry

280. Measurement of Reactive Oxygen Species, Reactive Nitrogen Species, and Redox-Dependent Signaling in the Cardiovascular System

investigators and clinical researchers avoid experimental error and ensure high-quality measurements of these important biological species. Introduction Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are produced in virtually all eukaryotic cells. These molecules regulate several physiological processes including proliferation, migration, hypertrophy, differentiation, cytoskeletal dynamics, and metabolism, but when available in excess, they react with lipids, proteins, and nucleic acids (...) Free radical; neutral form of hydroxide ion (HO − ) Superoxide anion Free radical; dioxide (1-); product of 1 e − reduction of dioxygen O 3 Ozone Trioxygen; an allotrope of oxygen OCl − Hypochloride anion Salt of hypochlorous acid ROOH Hydroperoxide Organic peroxide, protonated peroxyl radical ROO· Peroxyl radical Free radical; lipid peroxyl radical when R is a lipid carbon RO· Alkoxyl radical Free radical; lipid alkoxyl radical when R is a lipid carbon Reactive nitrogen species ·NO Nitric oxide

2016 American Heart Association

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